CPT 0420U: Cxbladder Detect Urine mRNA/SNP Test for Bladder Cancer Risk

CPT code 0420U is a Proprietary Laboratory Analyses (PLA) code for Cxbladder Detect (Pacific Edge Diagnostics USA LTD), a urine-based molecular diagnostic that measures mRNA expression of five genes and analyzes six single-nucleotide polymorphisms (SNPs) across two genes, with an algorithmic risk score to assess the likelihood of urothelial (bladder) cancer in symptomatic patients; the service is a laboratory molecular diagnostic assay typically performed in a clinical laboratory or reference lab and billed as a discrete lab test.

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CPT 0420U: Cxbladder Detect Urine mRNA/SNP Test for Bladder Cancer Risk

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Clinical & Coding Specifications

Clinical Context

A 64-year-old male presents to urology clinic with painless gross hematuria and intermittent dysuria. He has a 40–pack-year smoking history and a prior history of recurrent urinary tract infections. After initial evaluation including history, physical exam, and urinalysis, the urologist orders a urine-based molecular test, 0420U (Cxbladder Detect, Pacific Edge Diagnostics USA LTD), to assess mRNA expression of five genes and six SNPs to estimate the risk of urothelial (bladder) cancer. The specimen is collected as a voided urine sample at the clinic, labeled with patient identifiers, and shipped to the performing laboratory per manufacturer instructions. The lab performs RNA extraction, mRNA expression analysis, SNP genotyping, and algorithmic risk scoring. Results are returned to the ordering urologist within the lab’s reporting timeframe to guide the need for further evaluation such as cystoscopy, urine cytology, or imaging. Typical sites of service include outpatient urology clinics, ambulatory surgical centers for specimen collection, and the performing reference laboratory where analysis is completed.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81002`	Urinalysis, by dip stick or tablet reagent; non-automated, without microscopy	Performed at point of care as an initial screen before ordering `0420U`
`81025`	Urine pregnancy test, by visual color comparison methods	Performed in women of childbearing potential prior to invasive diagnostics though not directly related to `0420U`
`88112`	Cytopathology, fluids, washings or brushings, except gynecologic; basic, without interpretation of cell blocks	Urine cytology may be performed alongside `0420U` as a complementary test in bladder cancer evaluation
`52000`	Cystourethroscopy, with or without collection of specimen(s) by brushing or washing	Diagnostic cystoscopy often follows elevated risk from `0420U` to visually inspect and sample lesions
`88305`	Surgical pathology, gross and microscopic examination	If cystoscopy identifies lesion and biopsy is taken, pathology services are billed with codes like `88305` for histologic diagnosis

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
P5	Modifier P5 denotes a moribund patient who is not expected to survive without the operative procedure and is used only with anesthesia CPT codes 00100–01999. The anesthesia provider must append P5…	- Use modifier P5 only when the anesthesia provider determines the patient is moribund and not expected to survive without the operation, and append it only to anesthesia CPT codes 00100–01999…
33	Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…	- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
173000000X	Legal Medicine	The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical …
207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial p…
2080P0216X	Pediatric Rheumatology Physician	A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
2081P0004X	Spinal Cord Injury Medicine Physician	A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal c…
1835C0206X	Cardiology Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in direct patient care to ensure safe and effective use of medications in p…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
C67.3	Malignant neoplasm of anterior wall of bladder
C67.9	Malignant neoplasm of bladder, unspecified
D41.4	Neoplasm of uncertain behavior of bladder
N13.2	Hydronephrosis with renal and ureteral calculous obstruction
N20.0	Calculus of kidney
N20.1	Calculus of ureter
N21.0	Calculus in bladder
N21.9	Calculus of lower urinary tract, unspecified
N28.9	Disorder of kidney and ureter, unspecified
N32.81	Overactive bladder

Showing 1–10 of 26

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

Showing 1–10 of 536

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81002`	Urinalysis, by dip stick or tablet reagent; non-automated, without microscopy	Performed at point of care as an initial screen before ordering `0420U`
`81025`	Urine pregnancy test, by visual color comparison methods	Performed in women of childbearing potential prior to invasive diagnostics though not directly related to `0420U`
`88112`	Cytopathology, fluids, washings or brushings, except gynecologic; basic, without interpretation of cell blocks	Urine cytology may be performed alongside `0420U` as a complementary test in bladder cancer evaluation
`52000`	Cystourethroscopy, with or without collection of specimen(s) by brushing or washing	Diagnostic cystoscopy often follows elevated risk from `0420U` to visually inspect and sample lesions
`88305`	Surgical pathology, gross and microscopic examination	If cystoscopy identifies lesion and biopsy is taken, pathology services are billed with codes like `88305` for histologic diagnosis

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
P5	Modifier P5 denotes a moribund patient who is not expected to survive without the operative procedure and is used only with anesthesia CPT codes 00100–01999. The anesthesia provider must append P5…	- Use modifier P5 only when the anesthesia provider determines the patient is moribund and not expected to survive without the operation, and append it only to anesthesia CPT codes 00100–01999…
33	Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…	- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
173000000X	Legal Medicine	The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical …
207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial p…
2080P0216X	Pediatric Rheumatology Physician	A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
2081P0004X	Spinal Cord Injury Medicine Physician	A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal c…
1835C0206X	Cardiology Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in direct patient care to ensure safe and effective use of medications in p…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
C67.3	Malignant neoplasm of anterior wall of bladder
C67.9	Malignant neoplasm of bladder, unspecified
D41.4	Neoplasm of uncertain behavior of bladder
N13.2	Hydronephrosis with renal and ureteral calculous obstruction
N20.0	Calculus of kidney
N20.1	Calculus of ureter
N21.0	Calculus in bladder
N21.9	Calculus of lower urinary tract, unspecified
N28.9	Disorder of kidney and ureter, unspecified
N32.81	Overactive bladder

Showing 1–10 of 26

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

Showing 1–10 of 536

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 0420U: Cxbladder Detect Urine mRNA/SNP Test for Bladder Cancer Risk

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OpenPayer

CPT 0420U: Cxbladder Detect Urine mRNA/SNP Test for Bladder Cancer Risk

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

CPT 0420U: Cxbladder Detect Urine mRNA/SNP Test for Bladder Cancer Risk

Sign up for cpt 0420U policy alerts

CPT 0420U: Cxbladder Detect Urine mRNA/SNP Test for Bladder Cancer Risk

Sign up for cpt 0420U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What does CPT code 0420U represent?

In what clinical situation is Cxbladder Detect (0420U) typically ordered?

Where is the specimen collected and where is the assay performed?

What other CPT codes are commonly related to the evaluation pathway that includes 0420U?

Which diagnoses commonly trigger consideration of the Cxbladder Detect test billed with 0420U?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What does CPT code 0420U represent?

In what clinical situation is Cxbladder Detect (0420U) typically ordered?

Where is the specimen collected and where is the assay performed?

What other CPT codes are commonly related to the evaluation pathway that includes 0420U?

Which diagnoses commonly trigger consideration of the Cxbladder Detect test billed with 0420U?

References